No. 3--10--0556
Opinion filed May 3, 2011
_________________________________________________________________
IN THE
APPELLATE COURT OF ILLINOIS
THIRD DISTRICT
A.D., 2011
In re R.R. AND K.R., ) Appeal from the Circuit Court
) of the Tenth Judicial Circuit
Minors ) Peoria County, Illinois
)
(The People of the State of )
Illinois, )
) Nos. 10--JA--95
Petitioner-Appellee, ) 10--JA--96
)
v. )
)
Anna R. ) Honorable
) Richard D. McCoy
Respondent.) ) Judge Presiding.
_________________________________________________________________
JUSTICE LYTTON delivered the judgment of the court, with
opinion.
Justices Holdridge and McDade concurred with the judgment
and opinion.
_________________________________________________________________
OPINION
Anna R. is the mother of R.R. and K.R. When R.R. was just
over a month old, he was diagnosed with a skull fracture. As a
result, the State filed juvenile petitions, alleging that R.R.
and K.R. were neglected due to an injurious environment.
Following a hearing, the trial court found R.R. and K.R. to be
neglected minors. Thereafter, the court found Anna R. unfit,
made R.R. and K.R. wards of the court and placed them in the
guardianship of the Department of Children and Family Services
(DCFS). Anna R. appeals, arguing that the trial court’s neglect
and unfitness findings are against the manifest weight of the
evidence. We affirm.
Anna R. is the mother of R.R., who was born on February 19,
2010, and K.R., who was born on January 27, 2006. She is married
to Ryan R., who is the father of both R.R. and K.R.
On February 24, 2010, at a doctor’s visit, Anna R. mentioned
that R.R.’s lips had turned blue three times the day before.
R.R.’s doctor instructed Anna R. to take R.R. to the hospital.
R.R. was admitted to Saint Francis Medical Center on February 24,
2010. An MRI of R.R.’s brain was performed on February 27, 2010.
It showed a right frontal hemorrhage and posterior subdural
hematomas. A skeletal survey performed on March 1, 2010, showed
no skull fractures. R.R. was released from the hospital on March
1, 2010, with a diagnosis of apnea. Another skeletal survey was
performed on March 11, 2010, which showed no skull fractures.
On March 23, 2010, Anna R. brought R.R. back to Saint
Francis Medical Center for increased episodes of apnea. An MRI
of R.R.’s brain was performed on March 25, 2010. It showed new
areas of injury to the left and right temporal lobes. A skeletal
2
survey was performed on March 26, 2010. It showed a skull
fracture. R.R. was then referred to the Pediatric Resource
Center.
On April 5, 2010, the State filed juvenile petitions
alleging that K.R. and R.R. were neglected minors in that their
environment was injurious to their welfare because (1) R.R. was
diagnosed with a skull fracture and brain bleeds on March 23,
2010, which could not have occurred absent abuse or neglect on
the part of the caretaker, (2) following R.R.’s diagnosis, R.R.’s
mother and father repeatedly told authorities that they did not
know how R.R. was injured, and then on March 30, 2010, reported
that R.R.’s head hit a door while being held by his father, (3)
R.R. was diagnosed with a brain bleed and bruising to his back on
February 23, 2010, (4) Ryan R. committed domestic violence
against Anna R. on two occasions in 2006 when K.R. was present,
and (5) Ryan R. had a criminal record that included burglary,
consumption of alcohol by a minor and possession of drug
paraphernalia.
On April 26, 2010, Anna R. filed an answer to the juvenile
petition, stipulating that the State would call witnesses at
adjudication who would support all of the allegations contained
in the petition. However, she denied causing any injury to R.R.
She also stated that she did not think that R.R. "hitting his
3
head on the door was serious enough to mention" and that she was
"trying to cooperate." Finally, she denied seeing any bruising
on R.R.’s back on February 23, 2010.
An adjudicatory hearing was held on June 10, 2010. At the
hearing, the State entered into evidence medical records from
Saint Francis Medical Center that showed R.R. had brain bleeds on
February 27, 2010, but no skull fracture as of March 11, 2010. A
March 25, 2010, MRI showed new areas of injury to R.R.’s brain,
and a skeletal survey performed on March 26, 2010, showed a skull
fracture.
The State also introduced the report of Dr. Channing Petrak,
a physician at the Pediatric Resource Center. After physically
examining R.R. and reviewing his medical records and other
investigatory information, she concluded that the hemorrhage and
hematomas shown on R.R.’s February 27, 2010, MRI could have been
"due to birth." However, she found that the new injuries to R.R.
shown on the March 25, 2010, MRI were "clearly not due to birth
trauma." She found that they "were inflicted and due to abusive
head trauma." Additionally, she opined that R.R.’s skull
fracture was "inflicted." Dr. Petrak noted in her report that
Anna R. told police that she bumped R.R.’s head on a plastic
laundry basket and that Ryan R. told police that he accidentally
bumped R.R.’s head on the edge of a door. Dr. Petrak found that
4
"[n]either of these histories explains Ryan’s head injuries."
The State argued that R.R.’s injuries "could not have
happened absent abuse and neglect on the part of the caretaker
because these were intentionally inflicted on this minor." The
guardian ad litem, Linda Groezinger, said that she did not know
if R.R.’s injuries were intentional or accidental and, thus,
could not ask the court to find abuse or neglect.
Anna R. and Ryan R. denied inflicting any injuries on R.R.
Anna R. argued that R.R.’s brain injuries, including his skull
fracture, could have been accidental. The court ruled that based
on Dr. Petrak’s report, it had no choice but to find
"environmental neglect" by Anna R. and Ryan R. because of R.R.’s
injuries. The court did not attribute R.R.’s injuries to either
parent.
A dispositional hearing was held on July 12, 2010. At the
hearing, the trial court was presented with a report, dated June
25, 2010, from K.R. and R.R.’s caseworker, Danny Walker of
Counseling & Family Services. Walker found K.R. to be a "very
happy 4 year old girl," and R.R. to be "a healthy 5 month old
boy." He stated that he was "very optimistic about [K.R.] and
[R.R.] achieving reunification as both parents are engaged in
services and appear to be working diligently to correct the
conditions which brought this case to the attention of DCFS."
5
Walker recommended that Anna R. (1) be found fit, (2) participate
in and successfully complete individual psychotherapy, (3)
successfully complete a domestic violence class, (4) participate
in random drug testing, and (5) complete a psychiatric
evaluation.
Groezinger, the guardian ad litem, also recommended that
Anna R. be found fit. The State argued that Anna R. should be
found unfit based on R.R.’s "unexplained skull fracture." Anna
R. urged the court to accept Groezinger’s and Walker’s
recommendations and find her fit. At the time of the hearing,
Anna R. was attending domestic violence and parenting classes but
had not yet completed a psychiatric evaluation.
The trial court entered an order finding that it was in the
best interests of K.R. and R.R. to be made wards of the court,
with guardianship awarded to DCFS. The court found Anna R.
unfit.
I. Neglect
Anna R. argues that the trial court erred in finding R.R.
and K.R. neglected based on the report of Dr. Petrak because it
contained inadmissible hearsay. The State responds that the
trial court properly relied on Dr. Petrak’s report to find R.R.
and K.R. neglected.
Under section 2--3--1(b) of the Juvenile Court Act of 1987
6
(Act), a neglected minor includes "any minor under 18 years of
age whose environment is injurious to his or her welfare." 705
ILCS 405/2--3(1)(b) (West 2008). Generally, "neglect" is defined
as "the failure to exercise the care that circumstances justly
demand." (Internal quotation marks omitted.) In re Arthur H.,
212 Ill. 2d 441, 463 (2004). The term "injurious environment" is
generally "interpreted to include the breach of a parent’s duty
to ensure a safe and nurturing shelter for his or her children."
(Internal quotation marks omitted.) Id.
The terms "neglect" and "injurious environment" have fluid
meanings that vary with the facts and circumstances of a
particular case. In re J.C., 396 Ill. App. 3d 1050, 1056 (2009).
"Accordingly, cases involving allegations of neglect *** are sui
generis, and must be decided on the basis of their unique
circumstances." Arthur H., 212 Ill. 2d at 463.
At an adjudicatory hearing, the court is to focus solely on
whether the child has been neglected, not whether one or both of
the child’s parents are responsible for the neglect. Arthur H.,
212 Ill. 2d at 466. The court should not consider the acts
and/or omissions of the child’s parents in arriving at a
determination of neglect. Id. Proof of neglect of one minor is
admissible evidence on the issue of neglect of any other minor
for whom the parent is responsible. Id. at 468.
7
The State bears the burden of proving allegations of neglect
by a preponderence of the evidence. J.C., 396 Ill. App. 3d at
1056. On review, a trial court’s ruling of neglect will not be
reversed unless it is against the manifest weight of the
evidence. Arthur H., 212 Ill. App. 3d at 464. A finding is
against the manifest weight of the evidence only if the opposite
conclusion is clearly evident. Id.
An expert witness may not base his opinion on conjecture or
speculation. Mesick v. Johnson, 141 Ill. App. 3d 195, 205
(1986). However, a physician may testify to what might or could
have caused an injury even if the testimony is inconclusive. Id.
In forming their opinions, medical professionals can reasonably
rely on information known to them by their patients, by medical
records or by any other data reasonably relied upon by medical
professionals in forming opinions or inferences upon the subject.
Moran v. Erickson, 297 Ill. App. 3d 342, 353-54 (1998).
It is reasonable for a medical professional to rely on
information supplied by the patient or someone with an interest
in the patient’s well being. Moran, 297 Ill. App. 3d at 354;
People v. Roy, 201 Ill. App. 3d 166, 179 (1990). A medical
expert’s opinion as to the cause of injuries that is based on his
examination of the patient and the medical history related by the
patient is proper and admissible. See Mesick, 141 Ill. App. 3d
8
at 206.
Here, the State introduced as evidence the report of Dr.
Petrak, in which she opined that R.R.’s "head injuries, with the
exception of the possible birth injuries, were inflicted and due
to abusive head trauma." Anna R. did not object to the admission
of Dr. Petrak’s report but merely disagreed with Dr. Petrak’s
conclusion that R.R.’s head injuries were inflicted. She argued
that R.R.’s injuries could have been accidental but presented no
evidence or expert testimony to support her position.
Based on the evidence presented at the adjudicatory hearing,
the trial court’s finding of neglect was not against the manifest
weight of the evidence. The only medical opinion regarding
R.R.’s injuries was Dr. Petrak’s report. The report was proper
and admissible, as it contained Dr. Petrak’s medical opinion
based on her physical examination of R.R., information relayed to
her about R.R., and R.R.’s medical records. See Moran 297 Ill.
App. 3d at 353-54; Mesick, 141 Ill. App. 3d at 206. Furthermore,
Anna R. did not object to admission of the report, thereby
forfeiting any error on appeal and allowing the evidence to be
considered by the trier of fact. See People v. Ramsey, 205 Ill.
2d 287, 293 (2002).
According to Dr. Petrak, R.R. had head injuries that were
inflicted and caused by "abusive head trauma." Since R.R. was
9
just weeks old and had been solely in the care of Anna R. and
Ryan R. when he sustained those injuries, the trial court’s
finding that R.R. and K.R. were neglected is supported by the
evidence. See In re J.W., 386 Ill. App. 3d 847, 856-57 (2008)
(unexplained injuries to an infant were sufficient to establish
neglect).
II. Unfitness
Anna R. also argues that the trial court erred in finding
her unfit at the conclusion of the dispositional hearing since
the caseworker and guardian ad litem both recommended that she be
found fit.
In determining whether a neglected minor’s parent is fit to
care for the minor, the court must consider whether "the best
interest of the minor will be jeopardized if the minor remains in
the custody of his or her parents." 705 ILCS 405/2--27(1) (West
2008). We will reverse a trial court’s finding of unfitness only
if it is against the manifest weight of the evidence. In re
A.W., 231 Ill. 2d 92, 104 (2008). We give deference to the trial
court as to findings of fact and will not substitute our judgment
for that of the trial court. Id.
The trial court is not required to adopt a caseworker’s
recommendation that a parent be found fit. See In re K.R., 356
Ill. App. 3d 517, 523 (2005). Completing some required services
10
does not, in and of itself, make a parent fit, particularly where
other required services are still ongoing. See J.C., 396 Ill.
App. 3d at 1059-60.
Here, evidence admitted at the dispositional hearing
indicated that Anna R. was cooperating with DCFS and her
caseworker to complete the services required of her, including
parenting and domestic violence classes. Nevertheless, she still
had services to complete, including a psychiatric evaluation and
counseling. Although it appears that Anna R. is on her way to
becoming fit, in light of the unexplained injuries to R.R. and
Anna R.’s need to complete further services, the trial court’s
finding that Anna R. was unfit at the time of the dispositional
hearing was not against the manifest weight of the evidence.
The order of the Peoria County circuit court is affirmed.
Affirmed.
11